1. Technical Field
The present disclosure relates to bone fastener. In particular, the present invention relates to a series of bone fasteners for use in stabilizing a pair of adjacent vertebral facets to one another and to a method of operating the inventive bone fasteners.
2. Background of Related Art
It is often necessary to fix the facet joints of adjacent vertebrae to one another or to attach objects (e.g., bone plates, bone grafts, etc.) to a bone itself. For example, in repairing a fractured or damaged vertebra, it is often necessary to stabilize individual vertebrae in order to promote proper healing. Stabilization is often accomplished by fixing one vertebra to adjacent vertebrae or by using a bone plate, or pedicle screw and rod system, to interconnect adjacent or a series of vertebrae to one another.
Prior art techniques often utilize screws to secure vertebrae or bone to one another or to secure a plate and/or rods between individual vertebrae or between individual bones. In order to more securely anchor a screw into the vertebrae, bicortical placement of the screw into the bone is recommended. In other words, the screw is to penetrate through the cortex layer that is adjacent to the bone plate which is to be attached, then penetrate through the cancellous tissue in the interior of the bone and finally, penetrate into the opposite cortex layer on the opposite side of the bone.
Entering a bone is an invasive procedure that sometimes, based on the severity of problem which is encountered by an operating surgeon, requires that a screw penetrate through the opposite cortex layers. Accordingly, known screws have an elongated structure capable of bicortical purchase, otherwise the screws may loosen and fail to securely couple the plate to the bone or vertebrae.
Another known method is the use of pedicle screws for stabilizing adjacent vertebrae as well as for monosegmental or multisegmental fixation of a spinal column. Such screws typically do not obtain bi-cortical purchase and are therefore more susceptible to loosening. To help reduce this risk, the longest and largest size screw that can be safely inserted into the dense cancellous bone of the pedicle is used to maximize bone purchase. A typical pedicle screw includes a threaded portion and a receiver portion rigidly connected thereto at the head end of the screw. In use, several pairs of such screws are threaded into the vertebral bodies of the adjacent vertebra on either side of the spinal column through the pedicles. The respective receiver portions comprise receiving slits wherein a respective rod is passed through these receiving slits in the right and left hand group of pedicle screws. Thereafter, the rod is fixed to the respective receiver portion by means of fastening devices.
It is a drawback of this solution that it is difficult to rigidly insert screws through the pedicles on into the vertebral bodies and at the same time position the pedicle screws in two planes in exactly such a manner that the axes of the receiving slits in the receiver parts in the vertical columns align such that the rod may be passed through the receiving slits without distortion of the screws. Even with the advent of polyaxial screws, alignment of the receiving slits and contouring the rods to fit these slits remain a time consuming process. A further drawback is the difficulty in properly positioning the screws within the pedicles. This takes much skill on the part of the surgeon. Compromising the integrity of the cortical walls of the pedicle as well as further penetration into the vertebral body of the vertebra could lead to neurological complications and eventual implant loosening. Additionally, the implantation of a pedicle screw system is a very invasive procedure, whereby a large incision is made to expose multiple vertebral levels. This is largely due to the fact that the pedicles of adjacent vertebrae are not themselves directly adjacent, thus the need for the bar to interconnect the pedicle screws inserted into the vertebrae.
Still another drawback is that the holding power of pedicle screws greatly depends on the length and size of screw used. Increasing the length and size of a screw improves its holding power. However, as discussed above, using such screws that extend through the pedicle on into the vertebral bodies results in a more invasive and time-consuming procedure.
Furthermore, under normal circumstances, intervertebral discs support approximately 70-80% of axial loads imposed upon the lumbar spine, whereas the rest of such axial loads fall on spinal structures including, among others, the facet joints. As a rule, natural distribution of axial loads is, however, disturbed as a result of implantation surgery. Typically, the pedicle screws carry axial loads in excess of 20-30%. One of the reasons for such a deviation from the natural distribution is the concern that unless the vertebral motion segment to be fused is not adequately immobilized, fusion will not occur. As a result, rigid stabilization systems are necessary for the initial healing. Hence, the pedicle screws, viewed as a structure, which is capable of supporting greater axial loads, are characterized by intentionally massive configurations capable of extending through the vertebral bodies of the adjacent vertebrae. Once fusion has occurred, the extensive pedicle screw hardware is usually left in the patient. There is concern that leaving so much ‘foreign’ material behind could be detrimental to the patient. Finally, there is also a concern that existing pedicle screw systems may in fact be more rigid than necessary for a fusion to occur, and that a less rigid system that allows more ‘normal’ load sharing conditions may be preferable.
It is, therefore, desirable to provide a bone fastener configured to couple the facets of the adjacent vertebrae to be fused or bone fragments of the bone to be fixed and have a simple and reliable structure capable of stabilizing the adjacent facets during fusion or bone fragments.